Critics: Boutique doctors will further health care inequalities - wave3.com-Louisville News, Weather & Sports

Critics: Boutique doctors will further health care inequalities

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Dr. James Murphy Dr. James Murphy
Dr. Robert Ellis Dr. Robert Ellis
Dr. Mary Barry Dr. Mary Barry

LOUISVILLE, KY (WAVE) - A healthcare trend called "concierge medicine" is growing in popularity here in Kentuckiana. Concierge doctors offer same day appointments, no long waits and personalized care. But it all comes at a steep price.

Nicknamed "boutique doctors," concierge medicine carries the air of something just for the rich and the benefits are hard to argue. The question is what happens to those who can't afford to pay?

Dr. James Murphy has 1,500 patients, and it can be hard to pay attention to them and the bottom line.

"The expenses, the regulations, it's very difficult for a small practice to keep the lights on," Murphy said.

Dr. Robert Ellis used to have the same problem. Now, his 8,000 patient case load is down to 600 using the concierge medicine business model.

"It's immediate access," Dr. Ellis said. "For those people that are busy. Those people that are chronically ill."

In concierge medicine doctors require patients pay a subscription fee of sorts to be seen at their practice. In Dr. Ellis's case it's $1,650 a year.

Ellis said that money allowed him to cut the number of daily appointments 45 to 9. That means same day appointments and no more crowded waiting rooms for his patients.

"Our shortest office visit is 30 minutes," Dr. Ellis said. "Instead of my being the person going for the door the patient is."

Ellis's patients also get his cell phone number and access to other doctors around the country in the MDVIP system, which amounts to the concierge network Dr. Ellis is in.

The American Academy of Private Physicians says the number of concierge doctors is growing fast, up 25% in 2012 to 4,400 nationally. That's about 1.5 million Americans now paying for so called "boutique doctors."

Critics, like Dr. Mary Barry, worry there eventually will be a shortage of non-concierge doctors. That would mean even longer wait times and restricted access for low income patients and the formerly uninsured patients President Obama's Affordable Care Act is supposed to bring into the health care system.

"The way that medicine is set up, is to take care of everybody," Dr. Barry said. "But the way the country is set up is that not everyone gets treated equally."

"That is not the ideal we have always practiced but it is a reality of the class system in this country."

Dr. Ellis said concierge medicine is not a case of the have and have not's.

"It's people who want to have good care," Dr. Ellis said. "And I'm certain that better care is provided by this type of situation."

Dr. Murphy compares it to the choice between public and private school and says he's thought about going to the concierge system but hasn't, for fear Medicare patients like 73 year old Edna Dew might not be able to afford it.

"That would be a big decision," Dew said.

The choice between losing a doctor or adding to the rising cost of health care.

The government has studied this issue and concluded the concierge system does not violate any federal laws. And concierge doctors point to studies that show their patients have lower hospitalization rates that regular practices.

Dr. Bryan Loy, chief medical officer for Humana of Kentucky, provided Humana's perspective on concierge medicine.

"Humana is aware that some doctors' practices in our network offer concierge services," Dr. Loy said.

"From Humana's standpoint, all participating providers, including those offering concierge services, must comply with our policies and procedures. Humana patients still have to pay deductibles, co-payments and/or co-insurance based on their coverage. It is also important to note concierge fees will not be applied or factored into their coverage because it is not considered a medical expense."

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